Claims Adjuster

Risk Management Claims Investigator

Under general supervision, investigates, analyzes, and determines the extent of the City's liability involving accidents, incidents, or other occurrences involving city property, vehicles, or employees resulting in third-party personal injury or property damage. Interviews medical specialists, agents, witnesses, or claimants to obtain the facts of the incident; assembles all necessary evidence, including interviews, reports, site investigations, photographs, and all drawings prior to making a decision on the claim. Negotiates and prepares claims settlements and determines City liability based on valuation of injuries, medical reports, bills, estimates, and related facts. Denies claims when investigation reveals they are unsubstantiated. Processes liability and subrogation claims utilizing an electronic claim administration system. Documents the electronic file with claim activity and processes payments to vendors and claimants. Working conditions are primarily inside an office environment. Exercises no supervision. Work Location City Tower - 100 W Houston Street, San Antonio, Texas 78205 Work Hours 7 : 45 a.m. to 4 : 30 p.m., Monday - Friday

Essential Job Functions :

• Investigates allegations of negligence made by third-parties who have suffered a tort to determine legal liability.
• Collects documentation to determine the extent of damages to facilitate settlement of compensable claims.
• Prepares documentation memorializing claim activity in a Risk Management Information System and articulating liability analysis.
• Communicates with involved parties based on investigation and liability position.
• Establishes appropriate reserve levels based on financial exposure and provides appropriate documentation to explain any change in the reserve upon receipt of new information.
• Negotiates claim settlements based upon a determination of the City's liability and evaluation of the damages through review of medical reports, medical bills, statement of values, estimates, or other documentation provided to support a proof of loss.
• Prepares settlement memorandum to seek settlement authority and provides such documentation and direction to Claims Assistant to properly pay settlements and invoices.
• Annotates, categorizes, and addresses incoming claims correspondence including medical records and statement of values.
• Assists City Attorneys with the handling of litigated claims including active participation in mediation and settlement negotiations.
• Pursues subrogation of property damages sustained by the City of San Antonio or enforcement and collection of the workers' compensation lien incurred due to the compensable injury of an employee as a result of the negligence of a third party.
• Performs related duties and fulfills responsibilities as required.

Job Requirements :

Preferred Qualifications :

Applicant Information :

Knowledge, Skills, and Abilities :